Dementia can come on slowly. Only the Relatives of the 56 notice-year-old woman from Cap Verde, an island state off the North-West coast of Africa, only slight changes in your behavior. But at some point you no longer cleans, cooks, and talks to people that aren’t there. As you wrong one day, naked and disoriented, through the neighborhood, decides her sister to get to Portugal.

Only a few months later, the woman suddenly becomes unconscious and gets epileptic seizures, your sister will take you in the emergency room of a hospital. Upon arrival, the woman is awake again, the Doctors discover no neurological abnormalities. A blood image remains without result, also a CT of the brain shows no abnormalities. Since the first complaints, in the meantime, five years have passed.

The doctors prescribe the now 61-Year-old seizures, a remedy for spasm and send you for further Tests to a local neurologist. There is an EEG shows that the brain of woman works slows down. Fatigue can cause this condition for a short period of time. Among the long-term causes of the symptoms of the ageing process or as in the case of the woman – a dementia. Note on epilepsy do not provide the brain waves.

Nevertheless, the woman suffers another seizure. She takes the prescribed medications? When your family controls the taking of funds, disappearance of the seizures. The hallucinations remain. The woman tells her sister that you with the spirits of the dead Relatives communicate, you can see the people clearly in front. The spirits advise you to take your medication.

Paranoia sets in

In the further course of the disease, the 61-Year-old develops delusions. She is afraid that her family wants to poison you, denied to common meals. At the same time, she has to rely increasingly on the help of their Relatives. The woman can no longer leave the house alone, because they would not find their way back. The family is seeking psychiatric help, such as Doctors reports to Bruno Silva of the Nova Medical School in Lisbon, in the journal “BMJ Case Reports”.

Since the patient does not speak Portuguese, are instructed the physician on the translation help of the Relatives. The 61-Year-old knows it is not where she is, nor how late. Appearances can be deceiving, even her sister can’t understand some statements. From her behavior shows that she sees things and hears, have nothing to do with reality.

The doctors diagnose a progressive dementia, associated with either resulting or independently occurring epilepsy. The delusions may be independent of dementia and epilepsy, or as a result of the two diseases have occurred.

Only when you send the blood of the woman again into the lab, bumping into the doctor on a possible explanation for the complaints. The body of the woman is lacking in Vitamin B12. Extrapolated to one litre of less than 117 pmol of the substance floating in your blood from a value of 150 pmol of a defect.

Other explanations for a good treatable dementia, such as infectious diseases, hormonal complaints, or other vitamin deficiencies, may exclude the physician. MRI scans of the brain show no significant damage.

Gastroscopy and tissue analysis

Vitamin B12 is primarily in animal products, deficiency is often a result of a poorly planned vegan diet. In addition, diseases of the digestive tract are among the possible causes. This assumption is in the case of the woman.

The body needs a of the stomach skin is made of protein, Vitamin B12 via the intestines to absorb. Chronic gastro-intestinal disease can cause a deficiency of this substance, and as a result a lack of Vitamin B12 cause.

The psychiatrist to transfer the 61-Year-old for a gastroscopy a gastroenterologist who actually discovered signs of a gastric inflammation. Analyses of tissue samples to confirm that the woman suffers from a chronic inflammation of the gastric mucosa. The fabric is so heavily attacked that it is fading in some areas.

The woman there is likely to be for years to Vitamin B12. The nerves are in need of the fabric, the signals forward. He is missing, it can come out in addition to confusion, memory problems or psychosis even to paralysis. In most cases, it comes in addition to anemia. Since this is a typical complaint was lacking in the woman, not have doctors pulled the vitamin deficiency in earlier studies into consideration.

Injections to bypass the gut

The Doctors treat the woman with a neuroleptic, in schizophrenia and the hallucinations fixes. The patient, however, remains disoriented and helpless. These symptoms will disappear only when the doctors know the results of the blood tests and your Vitamin B12 to be administered.

The 61-Year-old turns back to the people, the Relatives of the time, knew before the disease. She cooks, helps in the household, shopping, orientation, and argues conclusively.

Nine months after the Disappearance of the hallucinations, the Doctors put the neuroleptic. Another half year later, the discomfort can return, however, the woman suffers from delusions of persecution. Again the Doctors to their patient to give an antipsychotic drug that relieves the discomfort quickly. The woman even developed a Kramp incurred after you settle your anti-epileptic drug.

That the symptoms, though the Vitamin-B12-budget, the woman is again set to lead the physician to possible nerve damage caused by the late diagnosis. The doctors advise their patient to take both the anticonvulsants and the antipsychotics more. In addition, they inject Supplement your once-a-month Vitamin B12. It goes well.